[Hiring] Senior Manager, Claims @Players Health

Role Description

Claims is where our promise to athletes and the organizations that protect them either holds up or doesn't. This role helps make good on that promise day to day — executing the claims function's strategy and playbook under the direction of our COO, and taking real ownership of how the work gets done as the function matures. This role will start as an individual contributor, with the opportunity to grow, build and lead a claims team as the function grows and the business matures.

The ideal candidate has 5+ years of experience in commercial insurance and claims, ideally within an MGA, TPA-managed program, or sports/specialty segment, with demonstrated experience executing claims strategy and managing TPA or vendor relationships. This role offers $92,000–$145,000, depending on skills and experience. This is a fully remote role, with preference for candidates in states where Players Health already has employee presence.

Players Health is a growing business, and we encourage employees to use technology to improve operations and workflows. Like any team building this way, not everything is fully systematized yet — at a company our size, you'll get real input into how this function is shaped, with meaningfully more influence than a similar role would carry at a larger organization.

Responsibilities

• Claims Operations & Process Improvement
  • Evaluate and provide proposed changes to the claims operating model — workflows, TPA relationships, technology, and vendor mix, identifying and surfacing gaps, as well as recommending improvements.
  • Contribute to build-vs-buy conversations, partnering with leadership to make decisions on claims technology, staffing, and outsourced services, and help define and track success metrics.
  • Build and maintain the playbook and standards for how claims get handled, audited, and improved as the function grows – creating a best-in-class claims experience.
• Claims Oversight, Quality & Compliance
  • Maintain oversight of commercial claims, including complex and litigated matters — validating coverage, liability, reserves, and settlement strategy, and directing TPAs, adjusters, and counsel.
  • Own the file audit and QC process: monitor SLAs, cycle times, litigation rates, and recovery performance, and develop remediation plans where standards slip.
  • Support internal and external audits, and MGA financial/regulatory reporting — carrier-specific and state-required submissions, surplus lines, and related compliance obligations.
  • Analyze claim outcomes across TPAs, jurisdictions, and programs to surface process and underwriting insights, and recommend improvements based on data.
• TPA Management, Data & Athlete Safety Insights
  • Serve as the primary point of contact for TPA relationships, submitting GL and A&H claims, coordinating loss run requests, and escalating issues to drive resolution.
  • Partner closely with Athlete Safety, providing claims data, loss trends, and risk insights that directly inform prevention and education efforts — helping improve our loss ratio and helping the organizations we insure manage risk more effectively.
  • Lead data cleanup across MGA and claims systems, and support system migrations, broker onboarding, and platform, process and workflow optimization as Players Health's tech stack matures.
  • Build and maintain claims dashboards that track trends, performance, and program health, translating claims data into insights that inform underwriting and risk decisions.
• Ownership & Execution
  • Own the day-to-day execution of the claims function, working autonomously in a remote environment while staying closely aligned with leadership on strategy and direction.
  • Help lay the groundwork for the future claims team - process documentation, standards, and onboarding structure - with the opportunity to lead and develop that team as it's built out.
  • Set clear standards and workflows for anyone supporting the function - TPA partners today, and any future claims team members as the team grows.
  • Model ownership, collaboration, and continuous improvement in support of organizational growth and mission alignment.
  • Other duties as assigned, including occasional travel for team engagement, collaboration, or events.

Qualifications

• 5+ years experience in commercial insurance or an MGA, with specific experience handling claims.
• Experience managing and/or supporting TPA relationships.
• Experience supporting and contributing to claims strategy and/or operating-model, and process decisions.
• Demonstrated experience evaluating or redesigning claims operating models, processes, or vendor structures.
• Experience working with TPAs, audits, and regulatory/carrier reporting.
• Strong analytical, organizational, and communication skills, with excellent interpersonal, negotiation, and conflict-resolution ability.
• Proven ability to manage time and meet deadlines while working autonomously in a remote environment.
• Ability to act with integrity, professionalism, and confidentiality.
• Baseline digital literacy: proficient with Microsoft Office/365 and comfortable adopting new tools and platforms as Players Health builds out its claims technology stack.

Desired Characteristics

• A bachelor's degree in business, risk, insurance, or a related field is desired.
• Demonstrated experience and/or ability to influence without authority.
• Demonstrated ability to build connections and rapport cross-departmentally.
• Participant/involvement in or strong understanding of the youth/amateur sports landscape.
• Prior experience building or scaling a claims function, ideally within an MGA or insurtech environment.

Additional Requirements

• Ability to travel occasionally for team events, collaboration, or conferences.
• Must have a dedicated, safe, and secure remote work environment.
• Must have the ability to work and be productive in a remote setting.
• Exceptionally self-motivated with the ability to work autonomously.
• Proactive communicator across email, verbal, and instant messaging.
• Willingness to attend virtual meetings, primarily with camera on (we value connection and culture).
• Located in or willing to work Central or Eastern Time Zone.
• Must be 18 years or older and work location must be in the United States.
• Must have unrestricted work authorization to work in the United States.